Gordon, Martin A.

Gordon, Martin A. is an individual health care provider with primary practice located at 1250 16Th St , Santa Monica CA 90404-1249. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gordon, Martin A. can be contacted via phone (310) 471-5852.

Contact Information

Primary practice address
1250 16Th St Santa Monica CA 90404-1249
Phone: (310) 471-5852
Fax: (310) 471-3958
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X C38040 California

Profile Details

NPI number 1508906090
LBN Legal business name Gordon, Martin A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Mar 20th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508906090 NPPES
California MEDICAID 00C38400

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